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HomeMy WebLinkAbout2012-190 Contract - National Research Center Contract for PERSONAL SERVICES less than $35,000 CITY OF CONSULTANT: National Research Center ASHLAND CONTACT: Damema Mann, Director 20 East Main Street National Citizen Survey Ashland, Oregon 97520 ADDRESS: 2955 Valmont Road, Suite 300, Boulder, CO Telephone: 541/488-6002 80301 Fax: 541/488-5311 TELEPHONE: 303-444-7863 x118 DATE AGREEMENT PREPARED: 8/1/2012 FAX: 303-444-1145 BEGINNING DATE: 8/21/2012 COMPLETION DATE: 2/1/2013 COMPENSATION: $16,000 ($10,300 for base survey plus $5,700 for additional options including demographic subgroup comparisons, custom benchmarks, one open-ended question, online web survey) SERVICES TO BE PROVIDED: Citizen Survey ADDITIONAL TERMS: None FINDINGS: Pursuant to AMC 2.50.120, after reasonable inquiry and evaluation, the undersigned Department Head finds and determines that: (1) the services to be acquired are personal services; (2)the City does not have adequate personnel nor resources to perform the services; (3) the statement of work represents the department's plan for utilization of such personal services; (4) the undersigned consultant has specialized experience, education, training and capability sufficient to perform the quality, quantity and type of work requested in the scope of work within the time and financial constraints provided; (5) the consultant's proposal will best serve the needs of the City; and (6) the compensation negotiated herein is fair and reasonable. NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT AGREE as follows: 1. Findings/Recitations. The findings and recitations set forth above are true and correct and are incorporated herein by this reference. 2. All Costs by Consultant: Consultant shall, at its own risk and expense, perform the personal services described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such service. 3. Qualified Work: Consultant has represented, and by entering into this contract now represents, that all personnel assigned to the work required under this contract are fully qualified to perform the service to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. 4. Completion Date: Consultant shall start performing the service under this contract by the beginning date indicated above and complete the service by the completion date indicated above. 5. Compensation: City shall pay Consultant for service performed, including costs and expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the contract be prematurely terminated, payments will be made for work completed and accepted to date of termination. 6. Ownership of Documents: All documents prepared by Consultant pursuant to this contract shall be the property of City. 7. Statutory Requirements: ORS 279C.505, 279C.515, 279C.520 and 279C.530 are made part of this contract. 8. Living Wage Requirements: If the amount of this contract is$19,494 or more, Consultant is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees performing work under this contract and to any Subcontractor who performs 50%or more of the service work under this contract. Consultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where it will be seen by all employees. 9. Indemnification: Consultant agrees to defend, indemnify and save City, its officers, employees and agents harmless from any and all losses, claims, actions, costs, expenses,judgments, subrogations, or other damages resulting from injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of whatsoever nature arising out of or incident to the performance of this contract by Consultant(including but not limited to, Consultant's employees, agents, and others designated by Consultant to perform work or services attendant to this contract). Consultant shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City. 10. Termination: Contract for Personal Services, Revised 06/30/2012, Page 1 of 5 a: Mutual Consent. This contract may be terminated at any time by mutual consent of both parties. b. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing and delivered by certified mail or in person. c. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of written notice to Consultant, or at such later date as may be established by City under any of the following conditions: i. If City funding from federal, state, county or other sources is not obtained and continued at levels sufficient to allow for the purchase of the indicated quantity of services; ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way that the services are no longer allowable or appropriate for purchase under this contract or are no longer eligible for the funding proposed for payments authorized by this contract; or iii. If any license or certificate required by law or regulation to be held by Consultant to provide the services required by this contract is for any reason denied, revoked, suspended, or not renewed. d. For Default or Breach. i. Either City or Consultant may terminate this contract in the event of a breach of the contract by the other. Prior to such termination the party seeking termination shall give to the other party written notice of the breach and intent to terminate. If the party committing the breach has not entirely cured the breach within 15 days of the date of the notice, or within such other period as the party giving the notice may authorize or require, then the contract may be terminated at any time thereafter by a written notice of termination by the party giving notice. ii. Time is of the essence for Consultant's performance of each and every obligation and duty under this contract. City by written notice to Consultant of default or breach may at any time terminate the whole or any part of this contract if Consultant fails to provide services called for by this contract within the time specified herein or in any extension thereof. iii. The rights and remedies of City provided in this subsection (d)are not exclusive and are in addition to any other rights and remedies provided by law or under this contract. e. Obligation/Liability of Parties. Termination or modification of this contract pursuant to subsections a, b, or c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such termination or modification. However, upon receiving a notice of termination (regardless whether such notice is given pursuant to subsections a, b, c or d of this section, Consultant shall immediately cease all activities under this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination, Consultant shall deliver to City all contract documents, information, works-in-progress and other property that are or would be deliverables had the contract been completed. City shall pay Consultant for work performed prior to the termination date if such work was performed in accordance with the Contract. 11. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City. Consultant shall have the complete responsibility for the performance of this contract. Consultant shall provide workers'compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to this contract. Consultant is a subject employer that will comply with ORS 656.017. 12. Assignment and Subcontracts: Consultant shall not assign this contract or subcontract any portion of the work without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be void. Consultant shall be fully responsible for the acts or omissions of any assigns or Subcontractors and of all persons employed by them, and the approval by City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and City. 13. Default. The Consultant shall be in default of this agreement if Consultant: commits any material breach or default of any covenant, warranty, certification, or obligation it owes under the Contract; its QRF status pursuant to the QRF Rules or loses any license, certificate or certification that is required to perform the Services or to qualify as a QRF if consultant has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in, or delegate duties under, the Contract. 14. Insurance. Consultant shall at its own expense provide the following insurance: a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to provide Oregon workers' compensation coverage for all their subject workers b. Professional Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each claim, incident or occurrence. This is to cover damages caused by error, omission or negligent acts related to the professional services to be provided under this contract. C. General Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property Damage. It shall include contractual liability coverage for the indemnity provided under this contract. d. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, or Not Applicable for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. Contract for Personal Services, Revised 06/30/2012, Page 2 of 5 e. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or intent not to renew the insurance coverage(s)without 30 days' written notice from the Consultant or its insurer(s) to the City. f. Additional Insured/Certificates of Insurance. Consultant shall name The City of Ashland, Oregon, and its elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only with respect to Consultant's services to be provided under this Contract. The consultant's insurance is primary and non-contributory. As evidence of the insurance coverages required by this Contract, the Consultant shall furnish acceptable insurance certificates prior to commencing work under this contract. The certificate will specify all of the parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If requested, complete copies of insurance policies; trust agreements, etc. shall be provided to the City. The Consultant shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self- insurance. 15. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or proceeding (collectively, "the claim") between the City (and/or any other or department of the State of Oregon) and the Consultant that arises from or relates to this contract shall be brought and conducted solely and exclusively within the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the District of Oregon filed in Jackson County, Oregon. Consultant, by the signature herein of its authorized representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United States Constitution, or otherwise, from any claim or from the jurisdiction. 16. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT, MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT. CONSULTANT, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS. 17. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Consultant understands and agrees that City's payment of amounts under this contract attributable to work performed after the last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this contract without penalty or liability to City, effective upon the delivery of written notice to Consultant, with no further liability to Consultant. Certification. Consults t shall sign the certification attached hereto as Exhibit A ond herein incorporated by reference. onsultan Ci shland By Signature De ,rtment Head I� �Jti KAar�6K Print game Print Name r slz�,I It Title Date W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. L Contract for Personal Services, Revised 06/30/2012, Page 3 of 5 EXHIBIT A CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS has notified it that it is no longer subject to backup withholding. Contractor further represents and warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the Contract, when executed and delivered, shall be a valid and binding obligation of Contractor enforceable in accordance with its terms, (c) the work under the Contract shall be performed in accordance with the highest professional standards, and (d) Contractor is qualified, professionally competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on behalf of the entity designated above and authorized to do business in Oregon or is an independent Contractor as defined in the contract documents, and has checked four or more of the following criteria: v (1) I carry out the labor or services at a location separate from my residence or is in a specific portion of my residence, set aside as the location of the business. ✓ (2) Commercial advertising or business cards or a trade association membership are purchased for the business. ✓/(3) Telephone listing is used for the business separate from the personal residence listing. (4) Labor or services are performed only pursuant to written contracts. (5) Labor or services are performed for two or more different persons within a period of one / year. (6) 1 assume financial responsibility for defective workmanship or for service not provided as evidenced by the ownership of performance bonds, warranties, errors and omission insurance or liability insurance relating to the labor or services to be provided. Contractor (Date) Contract for Personal Services, Revised 06/30/2012, Page 4 of 5 CERTIFICATE OF LIABILITY INSURANCE o&s 2 PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION JEFF OGBURN,STATE FARM INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 6560 GUNPARK DRIVE,STE A HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR BOULDER,CO 80301 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. A INSURERS AFFORDING COVERAGE NAIL• NVIURED INSURER A Stab FMm Firr AM CnurRy C=perly 26143 2$143 NATIONAL RESEARCH CENTER INC. INSURER B. 2935 VALMONT RD STE 300 INSURER G BOULDER,CO 80301.1380 INSURER D INSURER E: COVERAGES THE POLICIES OF INSURANCE USTED BELOW HAVE e N isgueb To THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLIVV LTR TOEOSINSURANCE POLICY NUMBER BATE EFFECOVE MTEIMhyFI TWA LOURS A x OEMERAL LJABUnY 9643U4823.8 1111812011 JIMO12012 EACH OCCURRENCE i 1,000000 COMNERCNL GENERAL UASXTY PREMISES spoor ma i 300,000 CLAIMS MADE X OCCUR MEDEXP(ArIT pM ) S 10,000 X HIRED AUTO LIABILITY MRSGNALSADV INJURY i X1 NON-OWNED AUTOS GENERAL AGGREGATE S 2,000,000 GENT.AGGREGATE UNIT APPLIES PER: PRODUCTS-COMPA)P AGO S X POLICY LAC i AUTOMOBLE LIABILITY 161-3304.1221-06 IIPM2011 111282012 COMBINED SINGLE LINT ANYAUTO IE°°�°'A f ALL OVMED AUTOS BODILY INJURY SCHEDULEDAUTOS (P-PV r 1.000.000 M*a HIREDAUTOS BODILY INJURY _NON-ONNEDAUTOS (pK gpp9M) $ 1,OOD,000 PROPERTY DAMAGE S 1,000,000 leer eaOemq) WiGGE IIABAJT'r ALTO ONLY-EA ACCIDENT i ANY ATO OTHER THAN EA ACC $ AUTO ONLY: AGG $ F-m I UMBRELLA LUALUTY EACH OCCURRENCE S OCCUR 171 CLAIM MADE AGGREGATE S E DEDUCTIBLE 5 RETENTION I S WORMERS COMPENSATION AND EMPLOYERS'LIABILITY NY LIMITS ER _ ANY PROPRIETORNARTNERIE%[tl1TNE YIN E.L.EACH ACCIDENT i O(FRCEPMEMMR EXC WDED? E.L DISEASE-EA EMPLOYE i y®,SeAtAWu f EL.DISEASE-POLICY LIMIT i OTHER BUSINESS PROPERTY 96-eU-3B23-8 11116!2011 1111612012 $75,100 DESCRIPTION OF oPEwwrioNal lDGTlpN6f VBSCLESr EXCLUSIONS ADDED BY ENOORBEMEIT1 SPECIAL PROVISIONS RESEARCH THE CITY OF ASHLAND,OR IS LISTED AS ADDITONAL INSURED. CERTIFICATE HOLDER CANCELLATION CITY OF ASHLAND,OR SHOULD ANY OF T E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CI EAST ASHLAND,OR DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN 20 ASHLAND,OR 97520 NOTICE TO THE CERnWATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SMALL IMPOSE NO OBLIGATION OR W®LMY OF ANY WND uPON WE INSURER TITS AGENTS OR REPRESENTATIM. AUTOO —REPRFSE TATNE�, JEFF OGBURN ACORD 25(2009101) ®1888-2009 ACCREYCORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1001486 132849.3 04-06-2009 ----- NAT1430 OP ID: MCI '414 R CERTIFICATE OF LIABILITY INSURANCE DAT08/16ND Y) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s. PRODUCER 303.781-6776 CONTACT NAME: FAX NEISEN BORTH AGENCY 303.789-4409 PHONE www.nbinsure.com Mc No EXt: INC,No: 333 W.Hampden Ave.Ste.410 E MAIIE55: Englewood,CO 80110 Nelsen Insurance,Inc. INSURER(S)AFFORDING COVERAGE NAIC0 INSURERA:Philadelphia Insurance Company INSURED National Research Center,Inc. INSURER B: 2955 Valmont Road Ste 300 Boulder,CO 80301 INSURER C INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFF POLICY UP LIMITS LTR TYPE OFINSURANCE POLICY NUMBER IMMIDDYYYY1 fMMJDDIYYYyI GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Ea ocwnence $ CLAIMS-MADE 71 OCCUR MED UP(Any one Person) $ PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ GENL AGGREGATE LIMIT APPLIES PER'. PRODUCTS-COMPIOP AGG $ POLICY PRO LOC $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea amdent $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDOS ULED BODILY INJURY(Peramdent) $ AUTOS AUT NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per amdenl S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EKCESS LIAB CI -MADE AGGREGATE S LIED RETENTIONS $ WORKERS COMPENSATION T RY LIAMIT j I ER AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YI❑N NIA E.L.EACH ACCIDENT S OFFICERNEMBER EXCLUDED? (Mendstory In NH) E.L.DISEASE-EA EMPLOYEE S If yes,demobs under DESCRIPTION OF OPERATIONS beb E.L.DISEASE-POLICY LIMIT S A Professional Liab PHSD686613 01101112 01101113 Prof Liab 2,000,00 A Cyber Security Lia PHSD702125 01101112 01/01113 Cyber Lia 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,ACdhionel Remerka SChWule,a more space la r uiresl) Certificate holder is The City of Ashland, OR, and its elected officials, officers and employees. The Professional Liability policy includes Errors 6 Omissions Coverage of $2,000,000 each claim,$2,000,000 annual aggregate, $5,000 deductible. CERTIFICATE HOLDER CANCELLATION CITYOAS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Ashland,OR THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN H ACCORDANCE WITH THE POLICY PROVISIONS. 20 East Main Street Ashland,OR 97520 AUTHORED RREPREESENTATNE ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 8 DATE(M WDO/YYYY) CERTIFICATE OF LIABILITY INSURANCE 08/16/12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT Aon Risk Services,Inc of Florida Risk Services,Inc of Flonda NAME: 1001 Bdckell Bay Drive,Suite#1100 PHONE IFAX Est),800-743-8130 INC.No):800-522-7514 Miami,FL 33131493] ADDRESS: ADP.COLCente on.com INSURER(s)AFFORDING COVERAGE NAIL# INSURERA: Ners Hampshire Ins Cc 23841 INSURED INSURER B: ADP TotalSouroe I,Inc. 10200 Sunset Onve INSURER C Miami,FL 33173 INSURER D: ALTERNATE EMPLOYER National Research Center Inc INSURER E, 2955 Valmont Road Suite 3110 Boulder,CO W301 INSURER F COVERAGES CERTIFICATE NUMBER:472819 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS SHOWN ARE AS REQUESTED. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY E%P LIMITS LTR INSR WD MMODIYYYY MWDCIYYYY GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea ccturience $ CLAIMS-MADE 7 OCCUR MED EXP(Any one person) $ PERSONAL S ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG E POLICY PROJECT LOC E WNSIN1,L)SINGLE AUTOMOBILE LIABILITY Ea accident E ANY AUTO BODI LY INJURY Per son E ALL OWNED SCHEDULED BODILY INJURY we ent E AUTOS I I AUTOS NONOMED MAGE HIRED AUTOS AUTOS Per accdent S $ UMBRELLA LIAB OCCUR EACH OCCURRENCE E EXCESS LAS CLAIMS-MADE AGGREGATE S DEC I I RETENTION E WORKERS COMPENSATION X WCSTATU- OTH- A AND EMPLOYERS'LIABILITY YIN WC 038087762 CO 07/01/12 07/01113 TORY LIMITS ER ANY PROPRIETORIPARTNEREXECUTIVE E.L EACH ACCI DENT S 2,000,000 OFFICERIMEMBER EXCLUDED? � NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE E 2,000,000 N vea.defence under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 E 2.000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more apace Is requlred) All wotksite employees working for the above named client company,paid under ADP TOTALSOURCE,INC's payroll,are covered under the above stated policy. The above named Gient is an altemate employer under this policy. CERTIFICATE HOLDER CANCELLATION City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 20 East Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ashland OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 0q01t dZAk(Se cs,&ee, 4/1c of(flo4ida ©1988.2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD , r C1 I Y RECORDER Page 1 / 1 �. CITY O F ASHLAND DATE PO NUMBER . 20 E MAIN ST. 8/30/2012 11135 ASHLAND, OR 97520 (541)488-5300 VENDOR: 015606 SHIP TO: City of Ashland NATIONAL RESEARCH CTR INC, NATIONAL CITI2 (541)488-6002 ry ATTN: DAMEMA MANN 20 E MAIN STREET 3005 30TH STREET ASHLAND, OR 97520 --' BOULDER, CO 80301 FOB Point: Req.No.: Terms: Net Dept: Req.Del.Date: Contact: Ann Seltzer Special Inst: Confirming? No ' Quantf Unit 7. ` . Description . ` - Unit Price ,Ext.Price Citizen Survey 16,000.00 Contract for Personal Services Beginninq date: 08/21/2012 Completion date: 02/01/2013 Insurance required/On file SUBTOTAL_ 16.000.0& BILL.TO:Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 541-552-2010 TOTAL 16,000.00 ASHLAND, OR 97520 . ;:Account Number '„. . Project Number-- Amount Account Number 'Project Number Amount E 710.01.02.00.604100 16 000.00 q AuthoraddSignatu re VENDOR COPY FORM #3 CITY OF A request for a Purchase Order ASHLAND REQUISITION Date of request: Required date for delivery: S P Vendor Name Address,City,State,Zip Contact Name&Telephone Number Fax Number SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form#13,Written findings and Authorization ❑ AMC 2.50 Dale approved by Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached ❑ Small Procurement Cooperative Procurement Less than$5,000 ❑ Request for Proposal (Copies on f le) ❑ State of Oregon ❑ Direct Award Date approved by Council: Contract# ❑ VerbalMrilten quote(s)or proposal(s) r ❑ Stale of Washington Intermediate Procurement �yu0leSource Contract# GOODS&SERVICES El Applicable Form(#5,6,7 or 8) ❑ Other government agency contract $5,000 to$100.000 El Written quote or proposal attached Agency (3)Written quotes attached form#4, Personal Services$5K to$75K Contract# PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement $5,000 to$75.000 E] Form#9,Request for Approval ❑ Agency ❑ Less than$35,000,by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council: El (3)Written proposals attached Date approved by Council: (Date) ❑ Form#4, Personal Services$5K to$75K Valid until: Date Description o/f' SERVICES Total Cost CLf;un ' Item# Quantity Unit Description of MATERIALS Unit Price Total Cost }TOT%►L CC0§T W' ❑ Per attached quotelproposal $ Project Number______-_ __ Account Number 2L0_-OL-a to_kdyido Account Number -__-__-__•______ Account Number___-__-__-__-______ 'Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support-Yes/No By signing this requisition to ,I certify that the City's public contracting require pt have been satis ed. Employee Signature: n Department Head Signature: �a^'t' (Equal too greater than$5,000) Additional signatures(if applicable): Funds appropriated for current fiscal year: 49/ NO A drr/�I ( Finance Director-(Equal to or r ter than$5,000) Date Comments: DUD% � L& 1 Form#3-Reauisifion CITY OF ASHLAND IFORM #4 DETERMINAT�Ii{ONS.TO PROCU_ RE i�ii`n^itiFJf.`�lr�. 6��.,"�°. PERSONAL SERVICES $5,000 to $75,000 To: Dave Kanner,Public Contracting Officer From: Ann Seltzer Date: August 7, 2012 Re: DETERMINATIONS TO PROCURE PERSONAL SERVICES 'In accordance with AMC 2.50.120(A), for personal services contracts greater than $5,000, but less than $75,000, the Department Head shall make findings that City personnel are not available to perform the services, and that the City does not have the personnel or resources to perform the services required under the proposed contract. However, the City Attorney, the Public Contracting Officer, or Local Contract Review Board, can require a formal solicitation for bids to ensure that the purposes of this chapter are upheld. Background The City of Ashland will conduct the National Citizen Survey(NCS) this fall. The survey includes the base survey, comparison to the NCS database of other jurisdictions nationwide, comparison to the 2011 Ashland survey, comparison to university communities with a population range of 10,000—40,000, demographic subgroup comparisons, an open-ended question, three Ashland specific questions and more. Results of this survey are statistically valid and will be used for 2013 Council goal setting and 2014 budget preparation. The estimated cost of the survey is $16,000. Administration included that amount in the FT2013 budget. Pursuant to AMC 2.50.120(A), has a reasonable inquiry been conducted as to the availability of City personnel to perform the services, and that the City does not have the personnel and resources to perform the services required under the proposed contract? The City of Ashland does not have the personnel or resources to conduct a survey nor does the City have a database of 500 other jurisdictions that have completed the same survey. Form#4-Department Head Determinations to Procure Personal Services,Page 1 of 1,8122/2012 CITY OF ASHLAND Memo DATE: August 7, 2012 TO: Kariann Olson, Purchasing FROM: Ann Seltzer, Management Analyst Cc: Dave Kanner, City Administrator RE: Sole Source, Citizen Survey The National Citizen Survey was developed by the National Research Center, Inc. and ICMA (International City/County Managers Association) to provide a statistically valid survey of resident opinions about their community and the services provided by local government. The National Research Center has a database of survey results from more than 500 jurisdictions throughout the country. This is the only survey administered with a database of that size and therefore our results can be compared to other jurisdictions. The City of Ashland wants to evaluate how Ashland"measures up" when compared to other communities. Page 1 of 1 10 26 10 memo sole source survey